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Sample Case Study on Drug Addiction

Case Study on Drug Addiction

Introduction
According to a recent report by the Royal College of Physicians (“Alcohol – can the NHS afford it?”), alcohol abuse is a growing concern in the UK, with more than one third of men and one fifth of women regularly consuming more alcohol than the recommended limits. The Scotsman recently reported that deaths related to alcohol consumption in Scotland have trebled in the last 20 years, and that alcohol-related health problems cost the Scottish NHS £100 million per year (Scotsman, 29/09/03). Drug misuse is also on the increase, with a Chamber of Commerce report claiming that illicit drug taking has increased by 30 percent in the last seven years. The Observer claims that ecstasy use has doubled to 2.2 percent of the population in the last five years, a higher proportion than in any other country apart from Australia and Ireland (Observer, 28/09/03).

The sheer scale of alcohol and drug abuse in the UK has obvious consequences for the workplace, especially when it is estimated that up to 75 percent of those with alcohol problems are currently in employment (Forum Issue 29). According to an article in People Management in May 2000, up to 14 million working days a year are lost across Britain due to alcohol-related absence. Ninety per cent of personnel directors from top UK organisations surveyed in 1994 (1995 HEA) stated that alcohol consumption was a problem for their organisation. A more recent study, (Drink, Drugs and Work) published in August 2000 reported that 60 percent of employers complained about employee problems due to alcohol misuse, and 27 percent about problems due to drug misuse.

Despite this, a CIPD study of organizations in the UK published in 2001 shows that around 40 percent of respondents had no formal policy on alcohol or drugs.

This report will identify some of the operational and strategic issues raised by alcohol and drug misuse in the workplace. It will then go on to explore the resources available to organizations looking to develop an alcohol and/or drugs policy and the possible problems associated with policy development. Theories on workplace health and surveys of organizational reality will underpin the evaluative side of the report.

Operational Issues
In the CIPD report “Alcohol and drug policies in UK organizations” (2001), companies cited a variety of operational issues that resulted in the introduction of an alcohol and/or drug policy. Employee absence was foremost amongst these, with 55 percent of respondents naming this as a reason for policy development. Up to 14 million working days are lost each year as a result of alcohol-related illness (People Management, May 2000). Loup (1994) states that drug and alcohol abusers are absent from work two to eight times more often that the average employee. The direct and indirect costs of employee absence are manifold and can include sick pay, overtime for colleagues covering the absence, the cost of hiring and training temporary or replacement staff and the time taken doing this, the demotivation and frustration of remaining staff, and possible further absence as a result. Labour turnover can also be affected, as drug and alcohol users tend to change jobs more frequently than average (Loup).

Disciplinary action as a result of alcohol or drug related incidents, and deterioration in individual performance also figured prominently in the CIPD report as reasons for developing policy, being invoked by 46 and 40 percent of companies respectively. Other responses included damage to customer/client relations (and presumably also damage to the company’s reputation and possible loss of business), decreasing productivity and rising accident levels. Butler (1994) suggests that an employee dependent on drugs may be up to 25 percent less productive than an average employee. Loup agrees with this and also highlights the likelihood of inferior product quality. Furthermore Loup states that the accident rate for drug abusers is about four times that of an average worker, and that up to 40 percent of workplace deaths can be related to drug abuse. The legal implications of accidents caused by workers who are under the influence of alcohol and/or drugs will be discussed later.

In the case of drug addiction, Loup and Eckersley (1995) both point out the danger of employees turning to theft, fraud and embezzlement as a means of financing an expensive habit.

Strategic Issues
The strategic issues associated with drug and alcohol abuse in the workplace are somewhat less straightforward. Firstly an employer must consider existing legislation surrounding drugs and alcohol in the workplace and its implications. Contentious issues include whether drug or alcohol addiction constitutes an illness, the ethical debate surrounding drug testing and monitoring employees outside of work. When developing a drug and/or alcohol policy, an organisation must heed such “best practice” guidelines as are applicable. Workplace culture surrounding alcohol and drugs, and employee attitudes towards new policy development also require scrutiny before an approach can be decided on. A company must also consider whether a stand-alone policy on alcohol and/or drugs can be effective, or if a general reconsideration of workplace health initiatives is necessary.

Relevant Legislation
The Misuse of Drugs Act 1971 has obvious relevance when illegal drugs such as cocaine or heroin are involved. This Act states that it is an offense to produce, supply or possess any drugs named under the Act, and any employer knowingly allowing drug use or other related activities at work may be committing an offense (HSE “Drug Misuse at Work”). However, in certain safety-critical occupations, alcohol abuse can also constitute illegal activity. The Road Traffic Act 1988 makes it illegal for anyone unfit through drink or drugs to be in charge of or to attempt to drive a motor vehicle in a public place. Under the Transport and Works Act 1992, transport system operators must show due diligence in preventing alcohol or drug abuse amongst their workers if they are to avoid criminal proceedings. As well as specific alcohol and drug legislation, an organisation must consider its more general duties under the Health and Safety at Work Act 1974 and the Management of Health and Safety Regulations 1999 to ensure, and assess risks to, the health, safety and welfare of its employees (HSE “Drug Misuse at Work”).

Despite the differing legal status of alcohol compared to most other drugs, companies are increasingly developing a single policy to cover the misuse of both alcohol and drugs. This trend is especially prevalent in safety-critical organizations, where policy development has been prompted by the Cannon Street rail crash and subsequent legislation. Seventy-five percent of safety-critical organizations have a combined drug and alcohol policy, compared to 35 percent of non-safety critical organizations (CIPD report, 2001). This would appear to reflect the attitude of most modern employers, which is that the precise substance involved is less important than its effect on employee health and impairment of performance. Alcohol and drug related problems are seen by over two-thirds of organizations as a combined health and disciplinary issue.

Addiction as an Illness
Recent legislation on employee rights such as the Employment Rights Act 1996 and the Disability Discrimination Act 1995 mean that dismissal is something of a minefield as far as employers are concerned. Although three of the five reasons for dismissal under the Employment Rights Act 1996 can cover the use of drugs or alcohol, addiction is classified as an illness by employment tribunals and as such must be treated like any other long-term health issue affecting an employee (Corbridge & Pilbeam, 1998). For this reason, organizations must be able to differentiate between a one-off incident of misconduct involving drugs or alcohol (which may warrant disciplinary action), and a problem with drink or drug addiction (which should be seen as a health issue first and foremost, although disciplinary action is not ruled out). ACAS best practice and government guides both stress that dismissing or taking disciplinary action against an employee with a drink or drug problem should be a last resort and should only come after every effort has been made to help. The attitude of the employee is also important in deciding how the matter is handled; the CIPD report states that in some companies, an employee volunteering information on their addiction will be dealt with more sympathetically than someone who attempts to conceal it. This is especially relevant in safety-critical organisations, where hiding a drug problem could result in fatalities and lead to the employer being charged with lack of due diligence in preventing the incident.

Identifying Alcohol and Drug Problems
It is not always easy to identify someone with a drug or alcohol problem. Increasingly companies are seeing the benefit of sending employees on alcohol and drug training programs to raise staff awareness and help people “learn the language” surrounding drugs (People Management, May 2000). The Health Education Board for Scotland’s “Alcohol and Drugs; Policies and Employment” is one such course. Monitoring key organizational areas can also help to uncover a problem. Decreased productivity, an increase in accidents or unexplained absences, behavioral changes and performance or conduct issues could indicate that there is an underlying substance abuse problem.

Another strategy available to employers in their bid to reveal alcohol and drug abuse is the highly controversial issue of drug testing. Testing, whether intended as a deterrent or to ensure capability of workers in safety-critical employment, raises issues of an individual’s rights to privacy (under Article 8 of the Human Rights Act). It also begs the question to what extent an organization has the right to control its employees’ activities outside of work. Opinion on the matter is sharply divided. Loup (1994) and Elmuti (1994) cite examples of increased productivity following the introduction of drug testing, whereas others concentrate on the high financial cost, the damage to employee/employer relations (Jardine-Tweedy & Wright, 1998) and the difficulty of ensuring the accuracy of results.

Possible Responses to Alcohol and Drug Problems

A company may choose from a range of reactive responses when dealing with an alcohol or drug problem. Discipline remains an option, but the HEA suggests several other initiatives which can be run in conjunction with the disciplinary process, including a program of awareness for all staff, a training program for manager or supervisors on recognizing the signs of drug use (although this does not address the problem of what to do if it is the manager who has the addiction), and encouraging those with a problem to seek help, either in the form of counseling or by undergoing a rehabilitation program.

However, reactive responses are unlikely to treat the root cause of addiction. The TUC points out the many ways in which an employer may actually be partly to blame for the employee’s problem. It states that workplace culture, a stressful working environment, long hours, working away from home and availability of alcohol or drugs at work are common ways in which work can literally “drive people to drink” or drugs (“A potent cocktail”, Jan 2003). It stresses the need for employers to take a holistic approach to employee health by coordinating a range of initiatives to form a coherent system for managing health, safety and welfare. These could include preventative strategies such as the promotion of a healthy lifestyle, as well as employee support through the provision of EAPs (Employee Assistance Programs) or “buddy programs” and counseling. Drink and drug awareness programs are still recommended, but as a matter of course rather than as a knee-jerk response. One way in which organizations with sufficient resources can coordinate different initiatives is to set up an OHS (occupational health service), although this may not be practical for small companies. This reflects the current government strategy promoting the development of OH issues outlined by the HSE in 1998.

Real Life Responses

Disciplinary action remains the most popular response to drugs and alcohol in both safety-critical and non-safety-critical organizations, according to the CIPD report. Alcohol, drug and stress counseling, referrals to an OH practitioner or GP, and paid time off for rehabilitation treatment are other popular reactions.

It would appear that the majority of respondents recognize the employer’s responsibility in providing a healthy, stress-free environment for employees, as over half have implemented preventative approaches in the form of stress management training, EAPs, specialized training programs, private health insurance and health promotion (CIPD, 2001).

Companies without a specific policy on alcohol or drug abuse appeared to be realizing the strategic importance of having such an initiative in place, with 45 percent of respondents stating that they were considering the introduction of a combined alcohol and drug policy.

Effectiveness of Responses
Over 70 percent of respondents offering EAPS and training to help management recognize employee problems and improve drug and alcohol practice believed these strategies were effective in helping to reduce drink and drug problems. Counseling was also cited as being an effective way of tackling alcohol and drug problems. The response to discipline as an effective way to deal with misuse problems was split, as disciplinary action was cited as both the most and the least effective strategy by organizations. However, larger numbers of respondents believed that discipline was the least effective approach than believed it was the most effective (CIPD, 2001). Respondents also believed that disciplinary action for drug or alcohol misuse needs to be combined with other strategies addressing the health and safety issues in order to be effective.

Conclusion

It would appear that more and more companies are realizing the importance of having a structured approach to dealing with alcohol and drug misuse in the workplace. The number of people affected by drug or alcohol abuse mean that ignoring the issue is not an option, as this is likely to result in a variety of operational and strategic problems for a company.

Absence and poor performance are two key operational issues raised by alcohol and drug abuse. Strategically, drug and health and safety legislation must be taken into account, as well as ACAS codes of practice and government guides on dealing with addiction and promoting healthy lifestyles.

Companies are being encouraged to look closely at their working culture to discover whether they may unwittingly be contributing to their employees developing drug or alcohol problems, and how they can best counteract this.

Industry research indicates that organizations are increasingly promoting a raft of preventative health strategies intended to help combat problems of misuse, as well as continuing to develop disciplinary frameworks. Not all companies take the same approach; safety-critical industry has of necessity developed a more hard-line approach viz-a-viz drug testing and impaired performance.

Whatever the chosen strategy, organizations which continue to ignore the issues raised by alcohol and drug misuse do so at their peril.

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